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活体肝移植供体肝胆管和血管解剖结构的检测:钆贝葡胺增强磁共振和 MDCT 血管成像的价值。

Detection of biliary and vascular anatomy in living liver donors: value of gadobenate dimeglumine enhanced MR and MDCT angiography.

机构信息

Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, Milano, Italy.

出版信息

Eur J Radiol. 2010 Nov;76(2):e1-5. doi: 10.1016/j.ejrad.2009.07.001. Epub 2009 Aug 7.

Abstract

OBJECTIVE

To evaluate the performance of magnetic resonance (MR) and multidetector computed tomography (MDCT) in the assessment of living donor's vascular and biliary anatomy, having surgical findings as reference standard.

METHODS

Thirty-two living liver donors underwent MR cholangiography (1.5-T; standard cholangiography pulse sequences and delayed acquisitions after administration of biliary contrast agent) for biliary anatomy evaluation. MDCT (16-row multidetector scanner, multiphase protocol, 3mm slice thickness) was also performed in all cases for the assessment of vascular anatomy before transplantation. Hepatic veins (<4mm in diameter) were not considered. MR and MDCT images interpretation was performed by two reviewers by consensus, based on source axial images, multiplanar reformats, and three-dimensional (3D) postprocessing images. Surgical intraoperative findings were used as standard of reference.

RESULTS

At surgery, 17 biliary anomalies, 3 portal anomalies, 32 venous and 8 arterial variants were found in the 32 patients. MR correctly identified 15/17 biliary anomalies, with a sensitivity of 88% and a specificity of 93%. MDCT correctly identified 8/8 arterial, 3/3 portal and 29/32 venous variants, with a sensitivity of 100% and 91%, respectively, and a specificity of 100%.

CONCLUSIONS

MR and MDCT proved to be efficient in evaluating living liver donor's biliary and vascular anatomy.

摘要

目的

评估磁共振(MR)和多排螺旋 CT(MDCT)在活体供者血管和胆道解剖结构评估中的性能,以手术结果作为参考标准。

方法

32 例活体肝移植供者接受了 MR 胆系造影(1.5T;标准胆系脉冲序列和胆汁对比剂给药后的延迟采集)以评估胆道解剖结构。所有病例均进行 MDCT(16 排多层螺旋 CT,多期扫描方案,3mm 层厚)以评估移植前的血管解剖结构。肝静脉(<4mm 直径)不考虑在内。MR 和 MDCT 图像的解读由两位审阅者通过共识进行,基于原始轴位图像、多平面重建和三维(3D)后处理图像。手术术中发现被用作参考标准。

结果

在手术中,32 例患者中发现了 17 例胆道异常、3 例门脉异常、32 例静脉和 8 例动脉变异。MR 正确识别了 15/17 例胆道异常,其敏感性为 88%,特异性为 93%。MDCT 正确识别了 8/8 例动脉、3/3 例门脉和 29/32 例静脉变异,其敏感性分别为 100%、91%和 100%,特异性均为 100%。

结论

MR 和 MDCT 被证明在评估活体肝移植供者的胆道和血管解剖结构方面是有效的。

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